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袖状胃切除术对中性粒细胞与淋巴细胞比值和血小板与淋巴细胞比值的影响及其与术后体重减轻的关系。

IMPACT OF SLEEVE GASTRECTOMY ON THE NEUTROPHIL-TO-LYMPHOCYTE RATIO AND THE PLATELET-TO-LYMPHOCYTE RATIO AND ITS RELATIONSHIP WITH POSTOPERATIVE WEIGHT LOSS.

作者信息

Iwanaga Tiago Cavalcanti, Santa-Cruz Fernando, Ferraz Álvaro Antonio Bandeira, Kreimer Flávio

机构信息

Universidade Federal de Pernambuco, Postgraduate in Surgery - Recife (PE), Brazil.

Universidade Federal de Pernambuco, Department of Surgery - Recife (PE), Brazil.

出版信息

Arq Bras Cir Dig. 2025 May 23;38:e1882. doi: 10.1590/0102-67202025000013e1882. eCollection 2025.

Abstract

BACKGROUND

Obesity represents a chronic pro-inflammatory status that contributes to accelerated atherosclerosis and cell aging. Besides the widely used C-reactive protein and ferritin, other inflammatory markers have gained attention, such as neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), which are related with the degree of inflammation in various pathological conditions, including obesity and its comorbidities.

AIMS

To compare and monitor the levels of NLR and PLR before and after sleeve gastrectomy (SG).

METHODS

Retrospective study that included a total of 622 patients with obesity who underwent SG as primer bariatric surgery in our center. Data regarding the presence of comorbidities, including type 2 diabetes (T2D), high blood pressure (HBP) and non-alcoholic fatty liver disease (NAFLD), variations in body weight and body mass index (BMI), and biochemical markers of inflammation, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and C-reactive protein (CRP) were gathered. Values of NLR and PLR were correlated with weight loss and prognosis of comorbidities within the postoperative period.

RESULTS

The sample was predominantly female (79.3%) with average age 36.91±10.04 years, with comorbidities including HBP (25.1%), T2D (8.0%), and NAFLD (80.1%). Patients with HBP showed reduced NLR and CRP post-intervention, while those with T2D experienced decreased CRP but increased PLR. Correlation analysis found no significant correlation between BMI/weight changes and NLR but significant correlation with PLR. Post-surgery, NLR decreased for previously NAFLD patients, and PLR increased.

CONCLUSIONS

According to the results, patients with obesity present a significant decrease in NLR and an increase in PLR after SG.

摘要

背景

肥胖是一种慢性促炎状态,会加速动脉粥样硬化和细胞衰老。除了广泛使用的C反应蛋白和铁蛋白外,其他炎症标志物也受到关注,如中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR),它们与包括肥胖及其合并症在内的各种病理状况下的炎症程度相关。

目的

比较并监测袖状胃切除术(SG)前后NLR和PLR的水平。

方法

一项回顾性研究,纳入了在本中心接受SG作为主要减肥手术的622例肥胖患者。收集了有关合并症(包括2型糖尿病(T2D)、高血压(HBP)和非酒精性脂肪性肝病(NAFLD))的存在情况、体重和体重指数(BMI)的变化以及炎症生化标志物(包括中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)和C反应蛋白(CRP))的数据。NLR和PLR的值与术后体重减轻和合并症的预后相关。

结果

样本以女性为主(79.3%),平均年龄36.91±10.04岁,合并症包括HBP(25.1%)、T2D(8.0%)和NAFLD(80.1%)。HBP患者干预后NLR和CRP降低,而T2D患者CRP降低但PLR升高。相关性分析发现BMI/体重变化与NLR之间无显著相关性,但与PLR有显著相关性。手术后,既往有NAFLD的患者NLR降低,PLR升高。

结论

根据结果,肥胖患者在SG后NLR显著降低,PLR升高。

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